Factors related to substance use development in young American Indian adolescents

描述（由申请人提供）：美国印第安青少年比美国许多其他群体更早开始使用药物，烟草和酒精，早期使用是长期和有问题使用风险的明确标志。在药物使用问题上，包括滥用和依赖性方面，存在着很大的差异，这是有据可查的。然而，尽管为应对这些差距做出了许多预防努力，但这些差距仍然很明显。我们的目标是更好地了解年轻的青少年美洲印第安人中的紧急物质使用，并确定可能提供预防机会窗口的风险和保护因素。使用来自其他人群的研究理论，补充我们所知道的有关物质使用的老年美国印第安人，我们已经确定了一个综合框架，了解早期物质使用的发展，在这个人口。这个框架结合了压力生活事件和青春期提前的影响，介导的同龄人的影响，并主持了父母和文化因素，我们的工作将探讨这些因素对早期物质使用的独特和综合影响。虽然这些影响中的一些已经在美洲印第安人中进行了研究（压力，同龄人，文化），但其他人只得到了粗略的关注（青春期提前，养育）。因此，还有很多工作要做，以告知那种经验为基础的预防计划，可能是成功的青少年在美国印第安社区。我们有一个独特的机会来探索这些影响早期物质使用的保留社区，有特别高的物质问题的发生率，建立在一个纵向评估的性风险预防计划，我们目前正在这个社区实施。在设计性风险研究的调查工具时，我们利用这个机会将与早期物质使用相关的措施也包括在内;因此，我们现在掌握的数据将使我们能够前所未有地了解这一人群中早期物质使用的发展情况。我们将解决以下4个具体目标：1）扩展描述的发展，药物，烟草和酒精的使用在美国印第安青年到青春期早期; 2）估计压力事件和早期物质使用发展之间的关系，在这一人群中; 3）确定是否青春期早期有一个重要的关系，以早期物质使用;探讨青春期早期如何与其他压力因素相互作用，影响风险，以及异常的同龄人影响如何调解这些联系; 4）探讨父母养育和部落文化的联系如何改变青少年早期物质使用的风险。这项工作将解决高风险和研究不足人群中的一个重大问题，使用一种利用现有数据的方法，并以创新的方式建立在现有的药物使用开发模型的基础上，有望推动该领域的发展。 公共卫生相关性：这项研究所针对的部落社区的青年比美国其他人面临更大的风险，因为他们出现了药物使用问题。随着我们更多地了解这些问题是如何在青少年早期出现的，我们将更好地确定预防干预工作的最佳时机和策略。这项工作还将有助于物质使用发展的理论模型，并扩大我们对早期使用相关因素的理解，这也可能对其他人群产生影响。

DESCRIPTION (provided by applicant): Use of drugs, tobacco, and alcohol starts earlier among American Indian adolescents than in many other groups in the U.S. and early use is a clear marker of risk for prolonged and problematic use. Significant disparities in substance use problems, including abuse and dependence, are well documented. Yet despite numerous prevention efforts in response to these disparities, they remain pronounced. Our goal is to better understand emergent substance use among young adolescent American Indians and identify risk and protective factors that may provide windows of opportunity for prevention. Using theories emanating from research with other populations, supplemented with what we know about substance use among older American Indians, we have identified an integrative framework for understanding early substance use development in this population. This framework incorporates the effects of stressful life events and early puberty, mediated by peer influences, and moderated by both parenting and cultural factors; our work will explore both the unique and combined effects of these factors on early substance use. While some of this array of influences have been examined among American Indians (stress, peers, culture), others have received little more than cursory attention (early puberty, parenting). Thus, much work remains to be done to inform the kind of empirically based prevention programs that are likely to be successful for young adolescents in American Indian communities. We have a unique opportunity to explore these influences on early substance use in a reservation community that has particularly high rates of substance problems, building on a longitudinal evaluation of a sexual risk prevention program that we are currently implementing in this community. In designing the survey instrument for the sexual risk study, we took advantage of the opportunity to include measures relevant to early substance use as well; thus, we now have data in hand that will allow us an unprecedented look at early substance use development in this population. We will address the following 4 Specific Aims: 1) Extend descriptions of the development of drug, tobacco, and alcohol use among American Indian youth into early adolescence; 2) estimate the relationship between stressful events and early substance use development in this population; 3) determine whether early puberty has an important relationship to early substance use; explore how early puberty interacts with other stressors to impact risk and how deviant peer influences mediate these links; and 4) explore how parenting and connection to tribal culture modify risk for early adolescent substance use. This work will address a significant problem in a high-risk and understudied population, use an approach that capitalizes on extant data, and build on existing models of substance use development in innovative ways that promise to move the field forward. PUBLIC HEALTH RELEVANCE: Youth in the tribal community targeted in this study are at relatively greater risk than others in the U.S. for developing substance use problems. As we learn more about how these problems emerge in early adolescence in this population, we will be better equipped to determine optimal timing and strategies for preventive intervention efforts. This work will also contribute to theoretical models of substance use development and broaden our understanding of factors related to early use, with likely implications for other populations as well.